Morla Olivier, Liberge Renan, Arrigoni Pierre Paul, Frampas Eric
Service de Radiologie Centrale, C.H.U. Hôtel Dieu, 1 place Alexis Ricordeau, 44000, Nantes, France,
Eur Radiol. 2014 Sep;24(9):2183-91. doi: 10.1007/s00330-014-3264-0. Epub 2014 Jun 5.
The purpose of this study was to review the clinical and CT findings of pulmonary nodules and masses in lung transplant recipients and to determine distinguishing features among the various aetiologies.
This retrospective study included 106 lung transplant recipients who had a chest CT performed over a 7-year period in a single institution.
Twenty-four cases of pulmonary nodules and masses were observed on CT. Among the single lesions, three (50%) were due to infections, one (17%) to organizing pneumonia, and two (33%) remained of undetermined origin. Among the multiple lesions, 14 (78%) were due to infection, three to post-transplant lymphoproliferative disorder (17%), and one to bronchogenic carcinoma (5%). The two main microorganisms were P. aeruginosa and Aspergillus spp. Among 12 solid nodules > 1 cm, four (33%) were due to malignancy: three post-transplant lymphoproliferative disorders (25%), and one bronchogenic carcinoma (8%). Among five cavitary nodules four (80%) were due to aspergillosis.
Infection is the most frequent aetiology of pulmonary nodules and masses in lung transplant recipients, but other causes such as post-transplant lymphoproliferative disorder, bronchogenic carcinoma, or organizing pneumonia should be considered.
Pulmonary nodules and masses are frequent in lung transplant recipients. Infection is the most frequent aetiology of solitary and multiple pulmonary nodules. Differential diagnosis includes post-transplant lymphoproliferative disorder, bronchogenic carcinoma, and organizing pneumonia. Clinical and CT findings are often non-specific. CT findings may be suggestive of some aetiologies that justify a biopsy.
本研究旨在回顾肺移植受者肺结节和肿块的临床及CT表现，并确定不同病因之间的鉴别特征。
这项回顾性研究纳入了在单一机构7年内接受胸部CT检查的106例肺移植受者。
CT检查发现24例肺结节和肿块。在单发病变中，3例（50%）为感染所致，1例（17%）为机化性肺炎，2例（33%）病因不明。在多发病变中，14例（78%）为感染，3例为移植后淋巴细胞增殖性疾病（17%），1例为支气管源性癌（5%）。两种主要微生物为铜绿假单胞菌和曲霉属。在12个直径>1 cm的实性结节中，4例（33%）为恶性病变：3例为移植后淋巴细胞增殖性疾病（25%），1例为支气管源性癌（8%）。在5个空洞性结节中，4例（80%）为曲霉病。
感染是肺移植受者肺结节和肿块最常见的病因，但也应考虑其他病因，如移植后淋巴细胞增殖性疾病、支气管源性癌或机化性肺炎。
肺结节和肿块在肺移植受者中很常见。感染是单发和多发肺结节最常见的病因。鉴别诊断包括移植后淋巴细胞增殖性疾病、支气管源性癌和机化性肺炎。临床和CT表现通常不具有特异性。CT表现可能提示某些病因，从而证明活检的合理性。
